The present exemplary embodiment relates generally to dental apparatus and methods. It finds particular application in conjunction with dental implants and methods, and will be described with particular reference thereto. However, it is to be appreciated that the present exemplary embodiment is also amenable to other like applications.
It is common for disease and/or injury to result in the loss of one or more natural teeth throughout a typical person's lifetime. As a result, a number of techniques have been developed to repair and/or replace such lost natural teeth with prosthetics.
In cases where natural teeth remain adjacent to the location where a prosthetic tooth is to be positioned, a fixed bridge may be fabricated. A fixed bridge utilizes one or both adjacent teeth to support the prosthetic tooth. In cases where insufficient natural teeth remain to support and stabilize a bridge, a partial or complete denture may be fabricated, with the denture seating against the patient's gingiva.
In still other cases, a dental implant may be used. A dental implant generally involves making a hole in the upper or lower jaw bone, as appropriate, and then fixing the distal end of the implant in the patient's recipient bone, such as by screwing a threaded implant into the bone. The dental implant is generally sized and positioned so that the proximal end of the implant protrudes at least partially into the space where the prosthetic tooth is to be positioned. Then the prosthetic tooth is fixed to the proximal end of the implant, such that the prosthetic tooth generally occupies the space of the lost tooth.
The current technique for dental implant surgery requires a multi-step process that includes multiple appointments with many procedures to accomplish the final aesthetic implant supported tooth replacement. With reference to FIGS. 1 and 2, in a first appointment an implant body IB is surgically placed in the dental alveolar bone B in direct relationship to the patient's existing dentition (e.g., between adjacent teeth T). After the implant body IB is surgically placed, a stock cylinder healing abutment C is placed and secured to the implant body IB.
The non-anatomical stock cylinder healing abutment C causes flattening of the interdental papilla P. The flattening of the interdental papilla P causes dark triangles and gum recession in the smile zone, as seen in FIG. 1. These dark triangles and gum recession are very difficult to correct after the initial healing period.
After four to six months of healing, the patient is seen by the restorative dentist to remove the stock cylinder healing abutment and place an impression post to take a physical impression. This will allow for a physical working model to be made in which a treatment crown can be fabricated at the lab and placed at the next visit. Multiple visits are used to contour the treatment crown in order to reestablish the tissue position (i.e., interdental papilla). This process sometimes involves the restoring dentist to sculpt free hand this anatomy in acrylic or resin material which is extremely time consuming. In addition, this process can have very unpredictable aesthetic results due to the loss of attachment during healing and the varying range of skills of the restoring practitioners.
Today, some dentists use digital scanning and milling machines (CAD-CAM technology) to fabricate onlays, inlays, veneers, etc., on natural teeth with a digitally generated model. These dental restorations can be prepared and placed on the same day (e.g., complete restorations in a single visit). When applying CAD-CAM technology to implant dentistry, a digital model cannot determine the most simple relationship of the implant to the dentition. In particular, conventional scanning techniques cannot determine the implant type (there are approximately 850 types), the diameter and shape of the platform, its orientation and placement location relative to the jawbone, existing teeth and gingiva. These details are essential for a properly designed restoration with a CAD-CAM system because the manner in which the prosthetic tooth mates with the implant impacts the alignment with the adjacent teeth and gingiva.